The Price of Medicare Procedures in Illinois



This table shows the 100 most frequently charged procedures/diagnosis in Illinois to the Inpatient Prospective Payment System (IPPS). This table will give a basic idea of the cost of medicare for hospital procedures. Hospitals determine what they bill according to a "chargemaster". The charge master serves as a price point for the beginning of negotiations between you and the health care provider.



ProcedureProvider StateTotal DischargesHospital Charge(s)Medicare Payment(s)Your Cost
Acute Myocardial Infarction Discharged Alive No Complications
 Illinois 746 $22542 $5541 $17001
Acute Myocardial Infarction Discharged Alive With Complications
 Illinois 1702 $30117 $7908 $22209
Acute Myocardial Infarction Discharged Alive With Major Complications
 Illinois 2947 $44910 $12124 $32786
Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications
 Illinois 3366 $9740 $5240 $4500
Atherosclerosis No Major Complications
 Illinois 1026 $15889 $4105 $11784
Back And Neck Proc Exc Spinal Fusion No Complications
 Illinois 1227 $31210 $7409 $23801
Bronchitis And Asthma No Complications
 Illinois 1012 $16142 $4643 $11499
Bronchitis And Asthma With Complications
 Illinois 1743 $23477 $6355 $17122
Cardiac Arrhythmia And Conduction Disorders No Complications
 Illinois 5646 $15251 $4043 $11208
Cardiac Arrhythmia And Conduction Disorders With Complications
 Illinois 5268 $21268 $5793 $15475
Cardiac Arrhythmia And Conduction Disorders With Major Complications
 Illinois 3188 $31273 $8519 $22754
Cellulitis No Major Complications
 Illinois 8088 $18733 $5908 $12825
Cellulitis With Major Complications
 Illinois 1076 $36058 $10065 $25993
Cervical Spinal Fusion No Complications
 Illinois 516 $59739 $16618 $43121
Chest Pain
 Illinois 7505 $16928 $4015 $12913
Chronic Obstructive Pulmonary Disease No Complications
 Illinois 6105 $17974 $5059 $12915
Chronic Obstructive Pulmonary Disease With Complications
 Illinois 7692 $24404 $6718 $17686
Chronic Obstructive Pulmonary Disease With Major Complications
 Illinois 7492 $30400 $8130 $22270
Circulatory Disorders Except Ami With Card Cath No Major Complications
 Illinois 5702 $33948 $7946 $26002
Circulatory Disorders Except Ami With Card Cath With Major Complications
 Illinois 1178 $59439 $15814 $43625
Cranial And Peripheral Nerve Disorders No Major Complications
 Illinois 1370 $24200 $6685 $17515
Degenerative Nervous System Disorders No Major Complications
 Illinois 1972 $22185 $6366 $15819
Diabetes With Complications
 Illinois 2548 $21008 $6163 $14845
Disorders Of Pancreas Except Malignancy With Complications
 Illinois 877 $28430 $7813 $20617
Dysequilibrium
 Illinois 2091 $19044 $4597 $14447
Esophagitis Gastroent And Misc Digest Disorders No Major Complications
 Illinois 13345 $19895 $5151 $14744
Esophagitis Gastroent And Misc Digest Disorders With Major Complications
 Illinois 2407 $31275 $8509 $22766
Extracranial Procedures No Complications
 Illinois 1240 $32784 $7207 $25577
Fractures Of Hip And Pelvis No Major Complications
 Illinois 1223 $16522 $4548 $11974
Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications
 Illinois 1283 $19075 $4842 $14233
Gi Hemorrhage No Complications
 Illinois 1877 $18250 $5012 $13238
Gi Hemorrhage With Complications
 Illinois 6882 $26358 $7033 $19325
Gi Hemorrhage With Major Complications
 Illinois 2485 $45373 $12466 $32907
Gi Obstruction No Complications
 Illinois 1657 $16763 $4447 $12316
Gi Obstruction With Complications
 Illinois 2522 $23942 $6398 $17544
Heart Failure And Shock No Complications
 Illinois 4905 $16995 $4812 $12183
Heart Failure And Shock With Complications
 Illinois 11539 $24443 $7163 $17280
Heart Failure And Shock With Major Complications
 Illinois 9549 $36712 $10214 $26498
Hip And Femur Procedures Except Major Joint No Complications
 Illinois 776 $38533 $10284 $28249
Hip And Femur Procedures Except Major Joint With Complications
 Illinois 3665 $50462 $12385 $38077
Hip And Femur Procedures Except Major Joint With Major Complications
 Illinois 814 $75439 $19684 $55755
Hypertension No Major Complications
 Illinois 1578 $16701 $4530 $12171
Infectious And Parasitic Diseases Or Procedure With Major Complications
 Illinois 2121 $127574 $38419 $89155
Intracranial Hemorrhage Or Cerebral Infarction No Complications
 Illinois 2723 $24632 $5882 $18750
Intracranial Hemorrhage Or Cerebral Infarction With Complications
 Illinois 5157 $32014 $8101 $23913
Intracranial Hemorrhage Or Cerebral Infarction With Major Complications
 Illinois 2881 $48704 $13179 $35525
Kidney And Urinary Tract Infections No Major Complications
 Illinois 10574 $19533 $5411 $14122
Kidney And Urinary Tract Infections With Major Complications
 Illinois 3474 $28601 $8101 $20500
Laparoscopic Cholecystectomy No Cde No Complications
 Illinois 810 $36088 $8631 $27457
Laparoscopic Cholecystectomy No Cde With Complications
 Illinois 917 $47496 $11932 $35564
Major Cardiovasc Procedures No Major Complications
 Illinois 1551 $94229 $23018 $71211
Major Gastrointestinal Disorders And Peritoneal Infections With Complications
 Illinois 1856 $27276 $8669 $18607
Major Joint Replacement Of Lower Extremity No Major Complications
 Illinois 20095 $53071 $14841 $38230
Major Joint Replacement Of Lower Extremity With Major Complications
 Illinois 911 $81615 $21725 $59890
Major Small And Large Bowel Procedures With Complications
 Illinois 2438 $67253 $18644 $48609
Major Small And Large Bowel Procedures With Major Complications
 Illinois 1888 $133297 $38297 $95000
Medical Back Problems No Major Complications
 Illinois 4548 $21686 $5693 $15993
Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications
 Illinois 9248 $17353 $4937 $12416
Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications
 Illinois 2978 $27848 $8329 $19519
Other Circulatory System Diagnoses With Complications
 Illinois 1019 $25994 $7292 $18702
Other Circulatory System Diagnoses With Major Complications
 Illinois 2791 $48875 $14157 $34718
Other Digestive System Diagnoses With Complications
 Illinois 2290 $25234 $7153 $18081
Other Kidney And Urinary Tract Diagnoses With Complications
 Illinois 1289 $25018 $7625 $17393
Other Kidney And Urinary Tract Diagnoses With Major Complications
 Illinois 1459 $39278 $11533 $27745
Other Vascular Procedures No Complications
 Illinois 1261 $52822 $11935 $40887
Other Vascular Procedures With Complications
 Illinois 2013 $72533 $18090 $54443
Other Vascular Procedures With Major Complications
 Illinois 1657 $87113 $24282 $62831
Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications
 Illinois 1215 $62765 $14244 $48521
Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications
 Illinois 4849 $65705 $14834 $50871
Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications
 Illinois 1049 $98072 $24403 $73669
Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications
 Illinois 1671 $60265 $12927 $47338
Peripheral Vascular Disorders No Complications
 Illinois 1115 $15549 $4805 $10744
Peripheral Vascular Disorders With Complications
 Illinois 2485 $23347 $6909 $16438
Permanent Cardiac Pacemaker Implant No Complications
 Illinois 1165 $55735 $13695 $42040
Permanent Cardiac Pacemaker Implant With Complications
 Illinois 1476 $69805 $18120 $51685
Poisoning And Toxic Effects Of Drugs No Major Complications
 Illinois 1277 $16789 $4522 $12267
Poisoning And Toxic Effects Of Drugs With Major Complications
 Illinois 252 $39364 $10994 $28370
Psychoses
 Illinois 8831 $14979 $7114 $7865
Pulmonary Edema And Respiratory Failure
 Illinois 3300 $34142 $8680 $25462
Pulmonary Embolism No Major Complications
 Illinois 1829 $27959 $7539 $20420
Red Blood Cell Disorders No Major Complications
 Illinois 5848 $19956 $5858 $14098
Red Blood Cell Disorders With Major Complications
 Illinois 1703 $32635 $9195 $23440
Renal Failure No Complications
 Illinois 822 $16259 $4544 $11715
Renal Failure With Complications
 Illinois 7154 $24747 $7044 $17703
Renal Failure With Major Complications
 Illinois 4847 $41041 $11762 $29279
Respiratory Infections And Inflammations With Complications
 Illinois 2584 $34888 $9677 $25211
Respiratory Infections And Inflammations With Major Complications
 Illinois 3002 $51004 $13436 $37568
Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs
 Illinois 1122 $132631 $38085 $94546
Respiratory System Diagnosis With Ventilator Support Less 96 Hrs
 Illinois 2855 $64580 $16645 $47935
Seizures No Major Complications
 Illinois 2890 $20446 $5661 $14785
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications
 Illinois 5001 $28109 $7726 $20383
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications
 Illinois 15610 $48201 $13223 $34978
Septicemia Or Severe Sepsis With Mv 96 Plus Hrs
 Illinois 1163 $136191 $41173 $95018
Signs And Symptoms No Major Complications
 Illinois 3330 $18649 $4973 $13676
Simple Pneumonia And Pleurisy No Complications
 Illinois 4080 $17950 $4908 $13042
Simple Pneumonia And Pleurisy With Complications
 Illinois 10041 $25731 $6879 $18852
Simple Pneumonia And Pleurisy With Major Complications
 Illinois 5916 $39486 $9878 $29608
Spinal Fusion Except Cervical No Major Complications
 Illinois 2321 $97282 $29406 $67876
Syncope And Collapse
 Illinois 8447 $19781 $5089 $14692
Transient Ischemia
 Illinois 4574 $21920 $5050 $16870


Source: CMS

As part of the Obama administration’s goal to make our healthcare more accountable, transparent and affordable the CMS.gov has released data from more then 3000 hospitals that receive payments for the 100 highest frequently billed charges under Medicare. For more information visit CMS.gov.

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